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Boateng ACO, Sebu J, Lekwauwa R, Britt KC, Oh H, Doolittle B. Religiosity & mental health seeking behaviors among U.S. adults. Int J Psychiatry Med 2024; 59:248-264. [PMID: 37390367 PMCID: PMC10832325 DOI: 10.1177/00912174231187841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
OBJECTIVES The association between religiosity and secular mental health utilization is unclear. Evidence suggests that religious and spiritual leaders (R/S leaders) may be more trusted than secular mental health therapists (SMHTs) and are often the first point of contact for individuals with mental health problems who identify as religious. METHODS Generalized equation estimate (GEE) analyses were used to examine the association between religiosity and mental health seeking behaviours in 2,107 participants using t Midlife in the United States Study (MIDUS) data collected between 1995 and 2014. RESULTS The final model indicated that after adjusting for covariates, higher levels of baseline religious identification and baseline spirituality (assessed in 1995) predicted an increase in visits to R/S leaders from 1995 to 2014 by a factor of 1.08 (95% CI=1.01-1.16) and 1.89 (95% CI=1.56-2.28), respectively. Higher levels of baseline religious identification reduced SMHTs visits by a factor of 0.94 (95% CI=0.90-0.98), whereas higher levels of baseline spirituality increased SMHTs visits by a factor of 1.13 (95% CI=1.00-1.27) during the same timeframe. CONCLUSION Higher levels of spirituality and religious identification increased the frequency over time of seeking mental health support from R/S leaders relative to SMHTs. Individuals with mental illness may seek support from religious resources, mental health professionals, or both, underscoring the importance of collaboration between R/S leaders and SMHTs. Mental health training for R/S leaders and collaboration with SMHTs may help alleviate mental health burden, especially among those who highly value their religious and spiritual beliefs.
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Affiliation(s)
- Augustine Cassis Obeng Boateng
- Department of Biobehavioral Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Spirituality and Health Hub, Philadelphia, PA, USA
| | - Joshua Sebu
- Spirituality and Health Hub, Philadelphia, PA, USA
- Department of Economics, University of Cape Coast, Cape Coast, Ghana
| | - Ruby Lekwauwa
- School of Medicine, Yale University, New Haven, CT, USA
| | - Katherine C. Britt
- Department of Biobehavioral Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Spirituality and Health Hub, Philadelphia, PA, USA
| | - Hayoung Oh
- Spirituality and Health Hub, Philadelphia, PA, USA
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Turner GW, Stayton WR. Are sex therapy and God, strange bedfellows? Case studies illuminating the intersection of client sexuality with spirituality, religion, faith or belief practices. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.2007235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - William R. Stayton
- Human Sexuality Studies, Widener University, Chester, Pennsylvania, USA
- Morehouse School of Medicine, Atlanta, Georgia, USA
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Freire J, Moleiro C, Rosmarin DH, Freire M. A call for collaboration: Perception of religious and spiritual leaders on mental health (A Portuguese sample). JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2018. [DOI: 10.1080/19349637.2017.1423001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Jaclin Freire
- CIS-IUL, Instituto Universitário de Lisboa ISCTE-IUL, Lisboa, Portugal
| | - Carla Moleiro
- CIS-IUL, Instituto Universitário de Lisboa ISCTE-IUL, Lisboa, Portugal
| | - David H. Rosmarin
- Harvard Medical School, McLean Hospital, Belmont, Massachusetts, USA
| | - Marina Freire
- Centro Universitário de João Pessoa, João Pessoa, Brazil
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Lawrence RE, Rasinski KA, Yoon JD, Curlin FA. Primary care physicians' and psychiatrists' willingness to refer to religious mental health providers. Int J Soc Psychiatry 2014; 60:627-36. [PMID: 24296966 DOI: 10.1177/0020764013511066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recent decades have witnessed some integration of mental health care and religious resources. AIM We measured primary care physicians' (PCPs) and psychiatrists' knowledge of religious mental health-care providers, and their willingness to refer there. METHODS A national survey of PCPs and psychiatrists was conducted, using vignettes of depressed and anxious patients. Vignettes included Christian or Jewish patients, who regularly or rarely attended services. We asked whether physicians knew of local religious mental health providers, and whether they would refer patients there. RESULTS In all, 896/1427 PCPs and 312/487 psychiatrists responded. Half of PCPs (34.1%-44.1%) and psychiatrists (51.4%-56.3%) knew Christian providers; fewer PCPs (8.5%-9.9%) and psychiatrists (15.8%-19.6%) knew Jewish providers. Predictors included the following: patients were Christian (odds ratio (OR) = 2.2-2.9 for PCPs, 2.3-2.4 for psychiatrists), respondents were Christian (OR = 2.1-9.3 for PCPs) and respondents frequently attend services (OR = 3.5-7.0 for PCPs). Two-thirds of PCPs (63.3%-64%) and psychiatrists (48.8%-52.6%) would refer to religious providers. Predictors included the following: patients regularly attend services OR = 1.2 for PCPs, 1.6 for Psychiatrists, depression vignette only), respondents were Christian (OR = 2.8-18.1 for PCPs, 2.3-9.2 for psychiatrists) and respondents frequently attend services (OR = 5.1-6.3 for PCPs). CONCLUSION Many physicians would refer patients to religious mental health providers. However, less religious PCPs are less knowledgeable about local religious providers.
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Affiliation(s)
- Ryan E Lawrence
- Department of Psychiatry, Columbia University Medical Center and the New York State Psychiatric Institute, New York, USA
| | - Kenneth A Rasinski
- Program on Medicine and Religion, University of Chicago, Chicago, IL, USA
| | - John D Yoon
- Program on Medicine and Religion, University of Chicago, Chicago, IL, USA Department of Medicine and the MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL, USA
| | - Farr A Curlin
- Program on Medicine and Religion, University of Chicago, Chicago, IL, USA Department of Medicine and the MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL, USA
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Durà-Vilà G, Littlewood R, Leavey G. Depression and the medicalization of sadness: conceptualization and recommended help-seeking. Int J Soc Psychiatry 2013; 59:165-75. [PMID: 22187003 PMCID: PMC4107836 DOI: 10.1177/0020764011430037] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Critiques of the validity of the DSM diagnostic criteria for depressive disorder argue that it fails to differentiate between abnormal sadness due to internal dysfunction or depression (sadness without an identifiable cause), and normal sadness (sadness with a clear cause). AIMS and METHODS A population survey was undertaken in adult education centres in Spain aiming to explore beliefs about depression and normal sadness. Two hypothetical case vignettes portrayed individuals experiencing deep sadness, both fulfilling criteria for major depressive disorder (DSM-IV), one with a clear cause, the other without an identifiable cause. Three hundred and forty-four (344) questionnaires were obtained (95% response rate). RESULTS Participants statistically significantly differentiated between the sadness-with-cause vignette, seen more frequently as a normal response, while the one without a cause was seen as pathological. Help-seeking behaviour recommendations followed this distinction: a medical option was statistically significantly more common when there was no cause for sadness. Socio-cultural variation in how people understand and deal with sadness was also found. CONCLUSIONS This study emphasizes the importance of taking into account the context in which depressive symptoms occur as it seems that the absence of an appropriate context is what makes people conceptualize them as abnormal. It also raises questions about the lack of face validity of the current diagnostic classification for depressive disorder that exclusively uses descriptive criteria.
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Affiliation(s)
- Glòria Durà-Vilà
- Research Department of Mental Health Sciences, University College London, London, UK.
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Lawrence RE, Rasinski KA, Yoon JD, Curlin FA. Religion and anxiety treatments in primary care patients. ANXIETY STRESS AND COPING 2013; 26:526-38. [PMID: 23286341 DOI: 10.1080/10615806.2012.752461] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Earlier data suggested that religious physicians are less likely to refer to a psychiatrist or psychologist. This follow-up study measures how religious beliefs affect anxiety treatments in primary care. We surveyed US primary care physicians and psychiatrists using a vignette of a patient with anxiety symptoms. Physicians were asked how likely they were to recommend antianxiety medication, see the patient for counseling, refer to a psychiatrist, refer to a psychologist or licensed counselor, encourage meaningful relationships and activities, and encourage involvement in religious community. We experimentally varied symptom severity, whether the patient was Christian or Jewish, and whether she attended religious services. Physician attendance at religious services was assessed in the survey. The response rate was 896 out of 1427 primary care physicians and 312 out of 487 psychiatrists. Religious physicians were more likely to promote religious resources. There was no statistically significant difference between physicians' recommendations for religious and nonreligious patients. There was no statistically significant difference in religious and nonreligious physicians' referrals to a psychologist, licensed counselor, or psychiatrist. Ultimately, we did not find a difference in religious and nonreligious physicians' support for mental health referrals, however, religious physicians were more likely to encourage using religious resources.
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Affiliation(s)
- Ryan E Lawrence
- a Department of Psychiatry, Columbia University Medical Center , New York State Psychiatric Institute , New York , NY , USA
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Greenidge S, Baker M. Why do committed Christian clients seek counselling with Christian therapists? COUNSELLING PSYCHOLOGY QUARTERLY 2012. [DOI: 10.1080/09515070.2012.673273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Unal S, Işeri E, Gürhan N, Sener S. Nonmedical healing methods: knowledge and behavior among parents of children with mental health problems. FAMILY & COMMUNITY HEALTH 2011; 34:349-358. [PMID: 21881422 DOI: 10.1097/fch.0b013e31822b555f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study examined knowledge and behavior concerning nonmedical healing methods used by parents whose children present with mental health problems and to determine the factors affecting this behavior. Knowledge of a variety of nonmedical health methods was found to be more common than use of such methods. Among those expressing knowledge of such methods, religious procedures were found to be more common than those that are nutrition related. Also, nonmedical healing method use increased as the mother's age decreased. We found a significant relationship between nonmedical healing method--using behavior and a positive family history of nonmedical healing method usage. Education about mental health problems and their treatment is very important, especially for young mothers. Increased understanding about nonmedical healing methods among health care providers will improve the patient-family-provider relationship.
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Affiliation(s)
- Sat Unal
- Psychiatric Nursing Department, Gazi University Health Sciences Faculty, Gazi University School of Medicine, Beşevler, Ankara, Turkey.
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Abstract
Clergy continue to have a central role in many communities and the utility of their involvement in the care of people with mental health problems is increasingly argued. However, there has been a failure to examine the form and parameters of partnerships between faith-based organisations and psychiatry.
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Leavey G, Loewenthal K, King M. Challenges to sanctuary: The clergy as a resource for mental health care in the community. Soc Sci Med 2007; 65:548-59. [PMID: 17482330 DOI: 10.1016/j.socscimed.2007.03.050] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2006] [Indexed: 10/23/2022]
Abstract
The transfer of psychiatric care from the institution to the community has presented community structures including faith-based organisations (FBOs) with an additional burden of care. In recent years there has been an increasing policy interest among government departments, public and non-statutory agencies for the inclusion of FBOs as partners in health and welfare services. However, despite their long historical involvement in healing and healthcare, clergy are seldom viewed by mental health professionals as partners in healing and restitution but with suspicion [Koenig, 1988. Handbook of Religion and Mental Health San Diego: Academic Press; Larson, Hohmann, & Kessler, 1988. The couch and the cloth: The need for linkage. Hospital and Community Psychiatry, 39, 1064-1069]. This may be compounded by ignorance about mental health care provision within FBOs in the UK and the preparedness, confidence and willingness to undertake such care. This paper is based on a study which examined clergy contact with people with mental illness. Thirty-two interviews were conducted with male clergy (Christian ministers, rabbis, and imams) most of whom were London-based. We examine barriers and dilemmas for clergy in caring for people with mental illness. We found that they play an important but often confined role the scale and impact of which is not recognised by their central organisation and training bodies. Low confidence about managing psychiatric problems, underscored by anxiety, fear and stereotyped attitudes to mental illness restrain their willingness to formalise their function. We argue that any proposed extension of clergy involvement in mental health will require further research and thorough deliberation by mental health services and religious organisations.
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Affiliation(s)
- Gerard Leavey
- Barnet, Enfield & Haringey Mental Health NHS Trust, London, UK.
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Mayers C, Leavey G, Vallianatou C, Barker C. How clients with religious or spiritual beliefs experience psychological help-seeking and therapy: A qualitative study. Clin Psychol Psychother 2007. [DOI: 10.1002/cpp.542] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kravitz RL, Franks P, Feldman M, Meredith LS, Hinton L, Franz C, Duberstein P, Epstein RM. What drives referral from primary care physicians to mental health specialists? A randomized trial using actors portraying depressive symptoms. J Gen Intern Med 2006; 21:584-9. [PMID: 16808740 PMCID: PMC1924631 DOI: 10.1111/j.1525-1497.2006.00411.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Referral from primary care to the mental health specialty sector is important but poorly understood. OBJECTIVE Identify physician characteristics influencing mental health referral. DESIGN Randomized controlled trial using Standardized Patients (SPs). SETTING Offices of primary care physicians in 3 cities. PARTICIPANTS One hundred fifty-two family physicians and general internists recruited from 4 broad practice settings; 18 middle aged Caucasian female actors. INTERVENTION Two hundred and ninety-eight unannounced SP visits, with assignments constrained so physicians saw 1 SP with major depression and 1 with adjustment disorder. MEASUREMENTS Mental health referrals via SP written reports; physician and system characteristics through a self-administered physician questionnaire. RESULTS Among 298 SP visits, 107 (36%) resulted in mental health referral. Referrals were less likely among physicians with greater self-confidence in their ability to manage antidepressant therapy (adjusted odds ratio [AOR] 0.39, 95% confidence interval [CI] 0.17 to 0.86) and were more likely if physicians typically spent > or =10% of professional time on nonclinical activities (AOR 3.42, 95% CI 1.45 to 8.07), had personal life experience with psychotherapy for depression (AOR 2.74, 95% CI 1.15 to 6.52), or usually had access to mental health consultation within 2 weeks (AOR 2.94, 95% CI 1.26 to 6.92). LIMITATION The roles portrayed by SPs may not reflect the experience of a typical panel of primary care patients. CONCLUSIONS Controlling for patient and health system factors, physicians' therapeutic confidence and personal experience were important influences on mental health referral. Research is needed to determine if addressing these factors can facilitate more appropriate care.
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Affiliation(s)
- Richard L Kravitz
- Center for Health Services Research in Primary Care and Department of Internal Medicine, University of California Davis, Sacramento, CA 95817, USA.
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Al-Krenawi A, Graham JR, Dean YZ, Eltaiba N. Cross-national study of attitudes towards seeking professional help: Jordan, United Arab Emirates (UAE) and Arabs in Israel. Int J Soc Psychiatry 2004; 50:102-14. [PMID: 15293428 DOI: 10.1177/0020764004040957] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Help-seeking processes provide critical links between the onset of mental health problems and the provision of professional care. But little is known about these processes in the Arab world, and still less in transnational, comparative terms. This is the first study to compare help-seeking processes among Muslim Arab female students in Jordan, the United Arab Emirates and Israel. AIMS The present study compares the attitudes of Arab Muslim female students from Israel, Jordan and the United Arab Emirates (UAE) towards mental health treatment. METHOD A convenience sample of 262 female Muslim-Arab undergraduate university students from Jordan, United Arab Emirates (UAE) and Arab students in Israel completed a modified Orientation for Seeking Professional Help (OSPH) Questionnaire. RESULTS Data revealed that nationality was not statistically significant as a variable in a positive attitude towards seeking professional help; year of study, marital status and age were found to be significant predictors of a positive attitude towards seeking help. High proportions of respondents among the nationalities referred to God through prayer during times of psychological distress. CONCLUSIONS The discussion considers implications for professional service delivery and programme development. Future research could extrapolate findings to other Arab countries and to Arab peoples living in the non-Arab world.
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Affiliation(s)
- Alean Al-Krenawi
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Israel.
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Wang PS, Berglund PA, Kessler RC. Patterns and correlates of contacting clergy for mental disorders in the United States. Health Serv Res 2003; 38:647-73. [PMID: 12785566 PMCID: PMC1360908 DOI: 10.1111/1475-6773.00138] [Citation(s) in RCA: 136] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To present nationally representative data on the part played by clergy in providing treatment to people with mental disorders in the United States. DATA SOURCES The National Comorbidity Survey (NCS), a nationally representative general population survey of 8,098 respondents ages 15-54. STUDY DESIGN Cross-sectional survey. DATA COLLECTION A modified version of the Composite International Diagnostic Interview was used to assess DSM-III-R mental disorders. Reports were obtained on age of onset of disorders, age of first seeking treatment, and treatment in the 12 months before interview with each of six types of professionals (clergy, general medical physicians, psychiatrists, other mental health specialists, human services providers, and alternative treatment providers). PRINCIPAL FINDINGS One-quarter of those who ever sought treatment for mental disorders did so from a clergy member. Although there has been a decline in this proportion between the 1950s (31.3 percent) and the early 1990s (23.5 percent), the clergy continue to be contacted by higher proportions than psychiatrists (16.7 percent) or general medical doctors (16.7 percent). Nearly one-quarter of those seeking help from clergy in a given year have the most seriously impairing mental disorders. The majority of these people are seen exclusively by the clergy, and not by a physician or mental health professional. CONCLUSIONS The clergy continue to play a crucial role in the U.S. mental health care delivery system. However, interventions appear to be needed to ensure that clergy members recognize the presence and severity of disorders, deliver therapies of sufficient intensity and quality, and collaborate appropriately with health care professionals.
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Affiliation(s)
- Philip S Wang
- Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
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